Mirna Rosa Sambula-Herbert, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

098533 Issued in NY

Practice address

2302 98TH St
East Elmhurst, NY 11369-1224

Phone

(347) 310-1153

NPI assigned

Jan 11, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Supportive Care Psychology of Ny PC

  • Clinical Psychologist
  • Howell, NJ
  • NPI 1104315068

  NY

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1357862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1588901458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2302 98TH ST",
            "city": "EAST ELMHURST",
            "state": "NY",
            "postal_code": "113691224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2302 98TH ST",
            "city": "EAST ELMHURST",
            "state": "NY",
            "postal_code": "113691224",
            "telephone_number": "347-310-1153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMBULA-HERBERT",
        "first_name": "MIRNA",
        "middle_name": "ROSA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-11",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "088518",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "098533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sahaara, Inc.
• Manisha Sahibdin, MS OTR/L
• Hannah Salazar Villavicencio, LCSW
• Christopher Salim
• Elizabeth Ann Sall, O.D.
• Anthea Samuels
• Karina Patricia Sanchez, OTR/L
• Luz S Sanchez, OTA
• Stephany Sanchez
• Leah Costales Sansano, PT

• Clinical Social Worker in East Elmhurst, NY
• Providers in East Elmhurst, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.